1. Field of the Invention
The present invention relates to laparoscopic instruments and, more particularly, to laparoscopic specimen removal apparatuses.
2. General Background
One of the biggest concerns in laparoscopic surgery is the number of laparoscopic instruments required to perform the surgical procedure and thus the number of incisions in the patient to insert such instruments. Therefore, several attempts have been made to integrate the functions of different laparoscopic instruments in such a manner that the number of incisions or trocar sites required to carry out the surgical procedure is minimized. However, any such integration of functions should not complicate the overall surgical procedure but instead simplify.
Before extracting the tissue or specimen from the patient's cavity, the tissue/specimen is placed in a receptacle such as, a bag, web or sheath to minimize further exposure of the other organs from the possibly diseased tissue/specimen being removed. As can be surmised, the bag or receptacle must be opened and/or deployed and, preferably, closed while in the patient cavity.
Several laparoscopic instruments have been patented which are used to assist in tissue removal during laparoscopic surgery.
U.S. Pat. No. 5,630,822, issued to Hermann et al., discloses a laparoscopic tissue removal device which includes a grasper coaxially mounted within an expandable sheath and including jaws for grabbing a specimen. However, a second tool must be used to tie off the sheath. Additionally, the use of other conventional laparoscopic grasping tools to push the mass into the flared end of the sheath is disclosed.
U.S. Pat. Nos. 5,190,555, issued to Wetter et al.; 5,336,227, issued to Nakao et al.; and, 5,352,184, issued to Goldberg et al. all disclose laparoscopic tools with a bag for capturing tissue, closing the bag via a drawstring and withdrawing it back through the tool.
U.S. Pat. Nos. 5,496,330, issued to Bates; 5,658,296, issued to Bates et al.; and, 5,197,968, issued to Clement all disclose a laparoscopic tools where the tool has a flexible basket for the tissue capture.
U.S. Pat. Nos. 5,176,687, issued to Hasson et al. and 5,312,417, issued to Wilk disclose laparoscopic tools with an open ended bag to capture tissue samples. In the Hasson et al. patent ('687), though a laparoscopic removal tool can be inserted through the bag, the bag must be pulled down out of a sleeve and opened with the assistance of a second tool, such as, forceps. The bag in '687 is made of a membrane which is not rigid and has no rigid supports to allow it to open on its own inside a patient. In the Wilk patent ('417), the receiver portion or open ended web (bag) is provided with support means to open and expand the open ended web (bag). Numerous proposals are suggested to open the receiver portion or web including complicated techniques using hydraulic or pneumatic circuits. Nevertheless, the invention described in '417 does not disclose any means in the laparoscopic cannula assembly which serves to close the open end of the web (bag) and, more specifically, the support means supporting the web (bag).
U.S. Pat. Nos. 5,190,1555, 5,336,227, 5,352,184, 5,496,330, 5,312,417, 5,197,968, 5,176,687; 5,630,822, 5,658,296, 5,423,830 are incorporated herein by reference.
U.S. Pat. Nos. 5,465,731 and 5,647,372, both of which are assigned to United States Surgical Corporation, disclose a specimen removal pouch and applicator which includes a pouch closed via a drawstring. An additional forceps or grasper inserted though another cannula may be need to unroll the pouch if necessary. The disclosed specimen removal pouch and applicator is not adapted to have a laparoscopic grasper or other laparoscopic instrument inserted coaxially through the applicator.
U.S. Pat. No. 5,480,404, issued to Kammerer et al., discloses a surgical tissue retrieval instrument including a collapsible pouch having a cinching mechanism. The instrument of Kammerer et al., like the applicator disclosed in '731 and '372, is not adapted to have a laparoscopic grasper or other laparoscopic instrument inserted coaxially therethrough.
U.S. Pat. No. 5,423,830, issued to Schneebaum et al., discloses an instrument assembly having a capture component including a web member attached to spring biased ribs which opens into a cup-shaped configuration when ejected. A vacuum or suction source is provided to provided a negative pressure to assist in clamping the web member and ribs around the tissue/specimen. The instrument assembly of Schneebaum is not adapted to have the cauterization loop inserted coaxially through the web.
U.S. Pat. No. 5,074,867, issued to Wilk, discloses a membrane or web having stings or filaments attached to the periphery or corners thereof. Forceps or the like are used to stretch the membrane until it assumes a substantially opened position which is shown as a flat sheet-like profile. The strings are used to surround the membrane or web around the specimen or organ.
As can be readily seen, there is a continuing need for a laparoscopic specimen removal apparatus including a laparoscopic specimen extractor having a specimen bag having support means for allowing the bag to be opened and closed without the use of a separate laparoscopic tool; and, a specimen grasper coaxially mountable within the specimen bag.